CRB DisclosureProof of Identity
NB:Current employer or Cumbria County Council Department must complete this form, not applicant.
E5 Cost Centre Code:
Details of ORIGINAL documents checked (please complete all fields for each)- refer to Group 1 and Group 2 lists on Page 2 for acceptable documents
Passport / Passport No.
Date of Birth
Photo / Licence No.
Date of Birth
Country of Issue /
Other:Birth Certificate / Date of Birth
Country of Issue /
(Delete as appropriate) /
CRB Disclosure Certificate/
Date of Issue
Type of Clearance
Other Forms of Identification
Please list documents seen that confirm the applicant’scurrent address1.
I confirm that I have checked these ORIGINAL documents with the applicant presentName (print):
Send Clearance certificate to:
(Line Manager Name)
Return completed form to:
Recruitment Team, CCC HR Service Delivery Centre, CapitaBuilding South Wing, KingmoorPark, CarlisleCA6 4SJ
Valid Identity Documents – Original documents only
All documents must be show applicant’s current name (marriage certificate excepted). At least one document must confirm the applicant’s current address and at least one document must confirm the applicant’s date of birth.
- If you can provide any document from Group 1 then you need to show:
Three documents in total:
All three from Group 1; or two from Group 1 and one from Group 2; or one from Group 1 and two from Group 2.
- If you cannot provide any document from Group 1 then you need to show:
Five documents in total from Group 2.Group 1
Passport (any nationality) / EU National Identity Card (EU Countries only)
UK Issued Driving Licence -England/ Wales/ Scotland/ Northern Ireland/ Isle of Man ; either photocard or paper ( A photo card is only valid if the individual presents it with the counterpart licence) / UKBirth Certificate - issued within 12 months of date of birth – full or short form acceptable including those issued by UK authorities overseas, such as Embassies, High Commissions and HM Forces
HM Forces ID Card (UK) / UKFirearms Licence
Adoption Certificate (UK)
Marriage/Civil Partnership Certificate, / Vehicle Registration Document (Document V5 old style and V5C new style only)
Financial Statement **
- e.g. pension, endowment, ISA / Court Claim Form** (UK) Documentation issued by Court Services
Birth Certificate / P45/P60 Statement (UK) **
Mail Order Catalogue Statement* / Bank/Building Society Statement*
Utility Bill* - electricity, gas, water, telephone – inc. mobile phone contract/bill / TV Licence**
Exam Certificate e.g. GCSE, NVQ, O Levels, Degree
Addressed Payslip * / Credit Card Statement *
National Insurance Card (UK) / Store Card Statement *
NHS Card (UK) / Mortgage Statement **
Benefit Statement* - e.g. Child Allowance, Pension / Insurance Certificate **
Certificate of British Nationality (UK) / Council Tax Statement (UK) **
Work Permit/Visa (UK) ** / A document from Central/ Local Government/ Government Agency/ Local Authority giving entitlement (UK)*:
e.g. from the Department for Work and Pensions, the Employment Service , Customs & Revenue, Job Centre, Job Centre Plus, Social Security
CRB Disclosure Certificate ** / Letter from a Head Teacher *
Connexions Card (UK) / One of the following documents from the United Kingdom Borders Agency (UKBA) (formerly the Immigration and Nationality Directorate – IND) (UK):
Do not use more than one of the following documents
Convention Travel Document (CTD) - Blue
Stateless Person’s Document (SPD) - Red
Certificate of Identity (CID) - Brown
Application Registration Card (ARC)
* Documentation should be less than three months old
**Issued within past 12 months
This list is subject to amendment.
CRB disclosure Proof Identity Document checklist v3.0 Aug10Page 1 of 2